Dysregulated TFR and TFH cells correlate with B-cell differentiation and antibody production in autoimmune hepatitis.

Follicular helper T (TFH) cell provides germinal centre (GC) B cell with critical signals for autoantibody production in the immunopathogenesis and progression of autoimmune hepatitis (AIH). However, the immunoregulatory functions of follicular regulatory T (TFR) cell in AIH are still unclear. The numbers of circulating TFR/TFH cells were measured in AIH patients. Moreover, we established experimental autoimmune hepatitis (EAH) model to examine the function of TFR cells on B-cell differentiation and autoantibody production in vivo and vitro. AIH patients had significantly increased numbers of TFH cells and decreased numbers of TFR cells as well as imbalanced TFR/TFH-type cytokines (IL-10, TGF-ß1 and IL-21) compared with healthy controls (HCs). In addition, TFR cell numbers negatively correlated with TFH cell numbers. Also, serum hypergammaglobulinaemia (IgG and IgM) concentration negatively correlated the levels of serum IL-21, but positively correlated with the levels of serum IL-10 in AIH patients. Furthermore, in comparison with control group, significantly higher frequencies of spleen TFR cells but lower frequencies of spleen TFH cells were detected in the EAH group. Further analysis found that TFR cells simultaneously express the phenotypic characteristics of Treg and TFH cells, but exercise as negative regulators of autoantibody production in vitro culture. Our findings demonstrated that dysregulated between TFR and TFH cells might cause excessive production of autoantibodies and destruction of the immune homeostasis, leading to the immunopathological process in AIH.

A rare case report of fungal esophagitis combined with giant gastric ulcer in an immunocompetent patient.

RATIONALE: Fungal infection of gastrointestinal (GI) tract is usually seen in immunocompromised patients, but can rarely occur in immunocompetent people in whom no permissive factor is present. PATIENT CONCERNS: We describe a 68-year-old male immunocompetent patient presenting with simultaneous fungal esophagitis and giant gastric ulcer. DIAGNOSES: Repeated endoscopic biopsies were taken from the giant gastric ulcer edge and base and histology demonstrated granulation tissue and pseudohyphal fungal forms. INTERVENTIONS: The patient was treated with fluconazole and omeprazole for 8 weeks. OUTCOMES: After antifungal treatment with fluconazole, the patient's clinical symptoms gradually disappeared with the healing of gastric ulcer, which never recurred in this patient until 3 months after follow-up. LESSONS: Nonhealing gastroesophageal ulcers highlights the importance of repeated endoscopies and biopsies.

Clinical application value of therapeutic endoscopic retrograde cholangiopancreatography in super-aged patients / 中国医师进修杂志

Objective To evaluate the value and safety of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients. Methods The clinical data of 377 elderly patients with therapeutic ERCP from January 2010 to September 2017 in Changzhou First People′s Hospital of Jiangsu Province were retrospectively analyzed. Among them, there were 34 patients (observation group) aged≥90 years and 343 patients (control group) aged 75 to 89 years old. The results of ERCP examination, treatment of bile duct stones and related complications were compared between 2 groups. Results There was no statistical difference in the success rate of ERCP between 2 groups (P＞0.05). There were no statistical difference in detection rates of bile duct stones, cholangiocarcinoma and benign biliary stricture between 2 groups (P﹤0.05); however, the detection rates of duodenal papillary carcinoma and nipple diverticulum in observation group were significantly higher than those in control group: 11.8% (4/34) vs. 2.0% (7/343) and 38.2% (13/34) vs. 18.7% (64/343), and there were statistical differences (χ2=10.326 and 7.294, P﹤0.01). There were 21 patients with bile duct stones in observation group, including 14 patients with multiple stones; there were 241 patients with bile duct stones in control group, including 188 patients with multiple stones. The maximum stone diameter, rate of in-line stent drainage and rate of extracorporeal lithotripsy in multiple stones patients of observation group were significantly higher than those in multiple stones patients of control group: (1.5 ± 0.3) cm vs. (1.2 ± 0.4) cm、9.5% (2/21) vs. 1.7% (4/241), 4.8% (1/21) vs. 0.4% (1/241), and there were statistical differences (P﹤0.05). There was no statistical difference in incidence of ERCP complications between observation group and control group: 14.7% (5/34) vs. 6.7% (23/343), P＞0.05; but the incidence of cardiac accidents in observation group was significantly higher than that in control group: 5.9% (2/34) vs. 1.2% (4/343), and there was statistical difference (χ2=4.393, P﹤0.05). There was no statistical difference in the length of hospital stay between observation group and control group: (11.5 ± 5.0) d vs. (13.2 ± 5.8), P＞0.05. Conclusions Therapeutic ERCP is an important treatment for elderly patients with biliary and pancreatic diseases. For patients over 90 years old, ERCP is safe and reliable, but it is necessary to actively pay attention to comorbidities, especially cardiac function.

Effects of Oridonin on Proliferation Apoptosis of Human Multiple Myeloma Cells H929 in Vitro / 中国实验血液学杂志

OBJECTIVE@#To investigate the effects of oridonin (ORI) on the proliferation and apoptosis of human multiple myeloma cell line H929 and its possible mechanism.@*METHODS@#H929 cells were exposed to ORI 0、4、8、12、16、20、24、28、32 μmol/L for 12, 24 and 36 hours respectively. The prolifcration inhibitory effect of ORI on H929 cells was determined by MTT assay and then the working concentrations of ORI were determined. The morphological changes and apoptosis of H929 cells were observed by TUNEL (TdT-mediated dUTP Nick-End Labeling) and fluorescence microscopy. The apoptosis rate of H929 cells was detected by flow cytometry with Annexin V-FITC/PI staining. The protein expressions of pro-caspase-3, BCL-2，p-PI3K, p-Akt, BAX, Cleaved PARP and p-JNK, p-ERK and p-p38 in H929 cells were detected by Western blot.@*RESULTS@#Compared with the control group, the proliferation of H929 cells treated with the ORI of 8-16 μmol/L was significantly inhibited and the apoptosis of H929 cells was obviously increased in dose- and time-dependent manners. As for morphological changes, the characteristics of apoptotic cells were presented in H929 cells treated with ORI for 24 hours. The protein levels of pro-caspase-3, BCL-2，p-PI3K, p-Akt were down-regulated with increasing of ORI concentration（r=0.9861, r=0.9725, r=0.9413, r=0.9373）, while the BAX, Cleaved PARP and p-JNK, p-ERK and p-p38 were up-regulated（r=0.9178, r=0.8877, r=0.882, r=0.9645, r=0.8623）.@*CONCLUSION@#The ORI possesses anti-myeloma effects, can inhibit the proliferation and induce the apoptosis of H929 cell line in vitro. Its potential mechanism may be related with up-regulating the MAPK and down-regulating the PI3K/Akt signal pathways.

Clinical application value of therapeutic endoscopic retrograde cholangiopancreatography in super-aged patients / 中国医师进修杂志

Objective@#To evaluate the value and safety of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients.@*Methods@#The clinical data of 377 elderly patients with therapeutic ERCP from January 2010 to September 2017 in Changzhou First People′s Hospital of Jiangsu Province were retrospectively analyzed. Among them, there were 34 patients (observation group) aged ≥ 90 years and 343 patients (control group) aged 75 to 89 years old. The results of ERCP examination, treatment of bile duct stones and related complications were compared between 2 groups.@*Results@#There was no statistical difference in the success rate of ERCP between 2 groups (P>0.05). There were no statistical difference in detection rates of bile duct stones, cholangiocarcinoma and benign biliary stricture between 2 groups (P<0.05); however, the detection rates of duodenal papillary carcinoma and nipple diverticulum in observation group were significantly higher than those in control group: 11.8% (4/34) vs. 2.0% (7/343) and 38.2% (13/34) vs. 18.7% (64/343), and there were statistical differences (χ2 = 10.326 and 7.294, P<0.01). There were 21 patients with bile duct stones in observation group, including 14 patients with multiple stones; there were 241 patients with bile duct stones in control group, including 188 patients with multiple stones. The maximum stone diameter, rate of in-line stent drainage and rate of extracorporeal lithotripsy in multiple stones patients of observation group were significantly higher than those in multiple stones patients of control group: (1.5 ± 0.3) cm vs. (1.2 ± 0.4) cm、9.5% (2/21) vs. 1.7% (4/241), 4.8% (1/21) vs. 0.4% (1/241), and there were statistical differences (P<0.05). There was no statistical difference in incidence of ERCP complications between observation group and control group: 14.7% (5/34) vs. 6.7% (23/343), P>0.05; but the incidence of cardiac accidents in observation group was significantly higher than that in control group: 5.9% (2/34) vs. 1.2% (4/343), and there was statistical difference (χ2 = 4.393, P<0.05). There was no statistical difference in the length of hospital stay between observation group and control group: (11.5 ± 5.0) d vs. (13.2 ± 5.8), P>0.05.@*Conclusions@#Therapeutic ERCP is an important treatment for elderly patients with biliary and pancreatic diseases. For patients over 90 years old, ERCP is safe and reliable, but it is necessary to actively pay attention to comorbidities, especially cardiac function.

A case report of endoscopic therapy for radiation-induced hemorrhagic gastritis in patient with recurrent hepatocellular carcinoma.

RATIONALE: Radiation-induced hemorrhagic gastritis is an infrequent cause of upper gastrointestinal bleeding and difficult to manage. The current standard treatment has not been well established. PATIENT CONCERNS: We described a 32-year-old male patient with hemorrhagic gastritis induced by external radiotherapy for hepatocellular carcinoma recurrence. DIAGNOSES: The endoscopic examination showed a diffuse area of bleeding in the gastric antrum. INTERVENTIONS: After failure of conventional hemostasis treatment, we successfully stopped the hemorrhage with repeated endoscopic argon plasma coagulation (APC) combined with low-dose polyglycerol sclerotherapy. OUTCOMES: The patient was followed up for 6 months to date without recurrence. LESSONS: Based on this case, we think that endoscopic APC combined with low-dose polidocanol sclerotherapy can be tried as a treatment for potentially life-threatening radiation-induced hemorrhagic gastritis.

Serum Levels of IL-33 and Correlation with IL-4, IL-17A, and Hypergammaglobulinemia in Patients with Autoimmune Hepatitis.

This study investigated the role of IL-33 in the pathogenesis of autoimmune hepatitis (AIH). The levels of IL-33/sST2 and Th1/Th2/Th17-type cytokines were determined by enzyme-linked immunosorbent assay in serum samples obtained from 30 AIH patients and 20 healthy controls (HCs). In addition, a murine model of experimental AIH (EAIH) was established to investigate the role of IL-33 in disease progression. The serum levels of IL-33, sST2, Th17 cytokines (IL-17A), Th1 cytokines (IFN-γ, TNF-α), and Th2 cytokines (IL-4) were significantly elevated in AIH patients compared to HCs. Following immunosuppression therapy, serum levels of IL-33 and sST2 were significantly decreased. Additionally, the serum levels of IL-33 in AIH patients were correlated positively with markers of hypergammaglobulinemia (IgG, IgM, and IgA) and liver injury (γ-GT/ALP). Also, the serum levels of IL-33 in AIH patients were correlated positively with proinflammatory cytokine levels (IL-17A and IL-4). Interestingly, treatment of EAIH mice with a specific IL-33 neutralizing antibody significantly reversed the increasing trend in serum ALT/AST and inhibited the production of the type 2 (IL-4) and type 17 cytokines (IL-17) but not the type 1 cytokine (IFN-γ). Our findings highlight the possible role of the IL-33/sST2 axis in the progression of AIH, opening a new door for developing a novel therapeutic strategy for AIH.

The Imbalance between Foxp3+Tregs and Th1/Th17/Th22 Cells in Patients with Newly Diagnosed Autoimmune Hepatitis.

This study is aimed at examining the potential role of regulatory T- (Treg-) Th1-Th17-Th22 cells in the pathogenic process of autoimmune hepatitis (AIH). The numbers of Foxp3+Tregs and Th1, Th17, and Th22 cells were measured in 32 AIH patients using flow cytometry. Moreover, a murine model of experimental autoimmune hepatitis (EAH) was also established and used to investigate the function of Treg-Th1-Th17-Th22 cells in disease progression. AIH patients undergoing an active state had significantly decreased numbers of CD3+CD4+CD25+Foxp3+Tregs and increased numbers of CD3+CD4+CD25-Foxp3+T, CD3+CD4+IFN-γ+Th1, CD3+CD4+IL-17+Th17, and CD3+CD4+IL-2+Th22 cells as well as higher levels of Th1/Th17/Th22-type cytokines compared to AIH patients in remission and HC. Additionally, the numbers of CD3+CD4+CD25+Foxp3+Tregs were negatively correlated with the numbers of Th1-Th17-Th22 cells. Also, the serum levels of IL-17A and IL-22 were correlated positively with liver injury (ALT/AST), whereas the serum levels of IL-10 were correlated negatively with hypergammaglobulinaemia (IgG, IgM) in AIH patients. Interestingly, the percentages of spleen Tregs, expression of Foxp3 mRNA, and liver IL-10 levels decreased, whereas the percentages of spleen Th1-Th17-Th22 cells, expression of T-bet/AHR/RORγt mRNA, and liver IFN-γ, IL-17, and IL-22 levels increased in the murine model of EAH. Our findings demonstrated that an imbalance between Tregs and Th1-Th17-Th22 cells might contribute to the pathogenic process of AIH.

Utility of preoperative voice therapy on the voice recovery of vocal cord polyps patients undergoing the microsurgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVES@#To evaluate the therapeutic effect on the voice recovery of patients with vocal cord polyps undergoing the microsurgery of preoperative voice therapy.@*METHODS@#Twenty-six patients diagnosed with unilateral vocal cord polyp under stroboscope, who needed to undergo vocal cord loss resection under supportive laryngoscope, were randomly divided into control group (non-voice training) and treatment group (voice training), with each group of 13 patients. Patients in control group were just treated with surgical operation. Apart from surgical treatment, patients in treatment group received 6 hours intensive vocal therapy one week before the surgery. The therapy courses consist of the propaganda and education of voice care, postoperative vocal instruction and the patients' self-training under the guidance of voice therapists. The acoustic parameters (irregularity, breathiness, grade, jitter and shimmer) of the same patient were collected 24 to 48 hours before the surgery and 14 days after the surgery with Ling WAVES. The results were analyzed with SPSS 19.0.@*RESULTS@#The differences of all the five preoperative voice parameters between control group and treatment group are not significant; but postoperative breathiness and jitter in treatment group were significantly lower than that in control group, while the differences of irregularity, overall severity and shimmer were not significant between control group and treatment group. In control group, breathiness and jitter were significantly improved after surgery, while the differences of irregularity, breathiness and shimmer were not significant between preoperation and postoperation. In treatment group, all the five voice parameters were significantly improved after surgery. According to the laryngostroboscopic examination, the vocal fold polyps were excised completely in both groups.@*CONCLUSIONS@#Preoperative voice therapy contributes to the recovery of voice quality of the patients with vocal cord polyps. Combined intervention of surgery and voice therapy is an effective method to treat the patients with vocal cord polyps.

Clinical control role of magnifying endoscopy with narrow-band imaging plus forceps biopsy for gastric low-grade intraepithelial neoplasia / 中国医师进修杂志

Objective To evaluate the clinical control role of magnifying endoscopy with narrow-band imaging plus forceps biopsy for gastric low-grade intraepithelial neoplasia detected by normalendoscopic biopsy. Methods This retrospective study enrolled 142 patients between January 2012 to December 2017, who were diagnosed as gastric LGIN by forceps biopsy in the first endoscopy examination and followed up by endoscopic surveillance. All the cases received endoscopic submucosal dissection or operation. One hundred and forty-two patients were divided into three groups according to different methods used to reexamine, including conventional white-light imaging (C-WLI) plus biopsy group, magnifying endoscopy with narrow-band imaging (ME-NBI) group and magnifying endoscopy with narrow-band imaging (ME-NBI) plus biopsy group. The consistent rate between the endoscopic-reexamined diagnosis and the pathologic diagnosis after ESD or operation in the three groups were compared. According to the pathologic diagnosis after ESD or operation, they were divided into two groups:the non-cancer group and the cancer group, the clinic and endoscopic characteristics between the non-cancer group and the cancer group were analyzed. Results The accuracy, sensitivity, specificity, NPV and PPV were significantly higher in ME-NBI group than those in C-WLI plus biopsy group and ME-NBI plus biopsy group:94.59％vs. 86.76％and 81.08％, 85.71％vs. 62.50％and 75.00％, 100.00％vs. 100.00％and 84.78％, 100.00％vs. 100.00％and 75.00％, 92.00％vs. 83.02％and 86.27％. As for the clinic and endoscopic characteristics, there was no statistically significant difference between the non-cancer group and the cancer group with age of patients, gender of patients, location of lesions, gastric mucosal atrophy, intestinal metaplasia and H.pylori infections (P>0.05). There was statistically significant difference with the size>1 cm, redness, nodularity and depression between the two groups (P<0.05). Conclusions Using the method of ME-NBI plus biopsy, actual high-grade intraepithelial neoplasia or early carcinoma can be differentiated from low-grade intraepithelial neoplasia so that treatment can be performed without delay.For the lesions of the size>1 cm, redness, nodularity and depression, they need to be reexamized as quickly as possible by the method of ME-NBI plus biopsy.

Targeting autophagy in multiple myeloma.

Autophagy plays an important role in plasma cell ontogeny and in the pathophysiology of multiple myeloma. Autophagy is usually considered a pro-survival mechanism, and cooperates with the ubiquitin proteasome system in maintaining the homeostasis of myeloma cells by degrading excessive and misfolded proteins for energy recycling. Therefore, the inhibition of autophagy could effectively induce death in myeloma cells, and could synergize with proteasome inhibitors. However, the excessive activation of autophagy could also lead to the extreme degradation of the organelles that induce autophagic cell death. Hence, the activation of autophagic cell death might also represent a promising approach for treating myeloma. Recent studies have demonstrated that autophagy also mediates drug resistance in myeloma cells and the complications of myeloma, while the inhibition of autophagy may reverse the response to drugs. In this study, we have mainly reviewed recent research on autophagy in relationship to the therapeutic effect, the reversal of drug resistance, and the mediation of complications.

Progress of autophagy in acute promyelocytic leukemia / 白血病·淋巴瘤

Acute promyelocytic leukemia (APL) is a special subtype of acute myeloid leukemia, characterized by the reciprocal chromosomal translocation of t (15;17)(q22;q21), which generates PML-RARαfusion protein. All-trans-retinoic acid (ATRA) and As2O3 could induce APL cells to differentiation and apoptosis, respectively, making APL become the first curable leukemia. Autophagy is one of metabolic mechanisms to maintain cell homeostasis. Recent studies have showed that autophagy plays an important role in the differentiation of APL cells induced by ATRA/As2O3. Meanwhile, autophagy may affect the sensitivity of APL cells to the pro-apoptotic effect of drugs. Therefore, targeting and regulating autophagy might be a new therapeutic approach of APL and even other leukemia in the future. This article will briefly review the advance of autophagy in APL in recent years.

Efficacy of endoscopic radial incision (ERI) for benign stricture of upper digestive system / 中国内镜杂志

Objective To evaluate the safety and efficacy of endoscopic radial incision (ERI) for benign stricture of upper digestive system. Methods Patients with benign esophageal or gastric stricture (including anastomotic stricture, stricture after ESD and caustic stricture) were enrolled in this study. The stage of stricture, length of the lesion and the thickness of the scar were recorded. ERI (maybe associated with balloon dilatation) were performed. Post-opera-tive symptoms, complications and follow-up were also recorded. Results 7 patients were enrolled and all received ERI, and 4 additional balloon dilatation were done. Dysphagia in all patients relieved. 1 case with hemorrhage oc-curred and relieved with conservative treatment. Majority of the patients got long-term remission after 1~2 times of ERI. Conclusion ERI is safe and effective for benign stricture of upper digestive system. It may prolong the dyspha-gia-free period, worth clinical promotion.

Comparative study on the clinical features of rotavirus gastroenteritis between the children with or without convul-sion / 临床儿科杂志

ObjectiveTo investigate the clinical features and prognosis of children with rotavirus gastroenteritis and convulsion.MethodsClinical data of children with rotavirus gastroenteritis hospitalized from January 2010 to December 2013 were retrospectively analyzed. Subjects were divided into the seizure group and no seizure group according to the presence of seizure in the course and compared between the two groups.ResultsThere were no signiifcant differences in sex, age, and the average duration of hospitalization between two groups (allP>0.05). The family history, history of seizures, the levels of serum sodium, calcium, lactate, standard bicarbonate concentration (SB), actual bicarbonate concentration (AB), carbon dioxide content (TCO2) and pH were statistically signiifcant between two groups (allP>0.05). During the follow-up period (outpatient telephone follow-up), the recurrence of seizure in two groups was signiifcant different (P<0.05) and only one (0.54%) child in seizure group developed epilepsy.ConclusionThis study showed that rotavirus gastroenteritis with convulsion is a benign clinical course.

Latest advances on the maintenance therapy of multiple myeloma / 中国实验血液学杂志

Multiple myeloma (MM) is an uncurable disease. Chemotherapy with standard dose or autologous stem cell transplantation (auto-HSCT) after chemotherapy with high dose is able to induce remission, but relapse still exists. For this reason the ultimate goal of MM treatment is to improve relapse free survival (RFS) and progression free survival (PFS) efficiently. Recently, maintenance therapy made substantial progress in improving progression-free survival and overall survival (OS) of patients with multiple myeloma, especially thalidomide, lenalidomide and bortezomib used in clinic. Here, the latest advances of clinical researches on maintenance therapy of MM are summarized briefly in this review.

FcγRIII a polymorphisms and efficacy of Rituximab combined chemotherapy for diffuse large B-cell lymphoma in Chinese patients / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the impact of Fc gamma receptor IIIa (FcγR IIIa) polymorphisms on the efficacy of rituximab (RTX) combined chemotherapy for patients with diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>FcγRIIIa polymorphisms were analyzed by PCR in 122 patients and 100 healthy controls. All patients received 8(4-12) cycles of RTX combined chemotherapy.</p><p><b>RESULTS</b>78(63.93%) patients with F/F, 5(4.10%) with V/V, and 39(31.97%) with V/F were identified, which were not different compared to controls. Patients with different FcγRIIIa genotypes did not have any difference in terms of gender, age, molecular subtypes, lactate dehydrogenase (LDH) or international prognostic index (IPI). The overall response rate (ORR) was 89.35% with a complete response (CR) of 80.33% and a partial response (PR) of 9.02%. The ORR was 83.33%, 100.00% and 100.00% in F/F, V/V and V/F, respectively. A higher response rate was observed in V/V and V/F as compared with F/F (P<0.05). With a median follow-up of 35 months (range: 12-62 months), 46(37.71%) patients had relapsed and 40 (32.79%) cases progressed and ended in death. The 3-year progress-free survival (PFS) rate was 41.03%, 100.00%, 100.00% in F/F, V/V and V/F, respectively. The 3-year overall survival (OS) rate was 48.72%, 100.00% and 100.00% in patients with three genotypes. The PFS and OS rate were significantly higher in V/V and V/F as compared with F/F (P<0.05).</p><p><b>CONCLUSION</b>FcγR III a polymorphisms could predict response and prognosis of RTX combined chemotherapy for patients with DLBCL.</p>

Halobellus rarus sp. nov., a halophilic archaeon from an inland salt lake of China.

Two halophilic archaeal strains, YC21(T) and YC77, were isolated from an inland salt lake of China. Both have pleomorphic rod-shaped cells that lyse in distilled water, stain Gram-negative and form red-pigmented colonies. They are neutrophilic, require at least 2.1 M NaCl for growth under the optimum growth temperature of 37 °C. The major polar lipids of the two strains were phosphatidylglycerol (PG), phosphatidylglycerol phosphate methyl ester (PGP-Me), phosphatidylglycerol sulfate (PGS), two major glycolipids (GL1 and GL2) chromatographically identical to sulfated mannosyl glucosyl diether (S-DGD-1) and mannosyl glucosyl diether (DGD-1), respectively. Trace amounts of two unidentified lipids (GL0-1 and GL0-2) were also detected. The 16S rRNA gene sequences of the two strains are 99.9 % identical, show 94.0-98.9 % similarity to the closest relative members of Halobellus of the family Halobacteriaceae. The rpoB' gene similarity between strains YC21(T) and YC77 is 99.8 % and show 90.3-95.3 % similarity to the closest relative members of Halobellus. The DNA G+C content of strains YC21(T) and YC77 were 66.1 and 66.2 mol%, respectively. The DNA-DNA hybridization value between strain YC20(T) and strain YC77 was 89 %, and the two strains showed low DNA-DNA relatedness with Halobellus limi TBN53(T), the most related member of Halobellus. The phenotypic, chemotaxonomic and phylogenetic properties suggest that strains YC21(T) and YC77 represent a novel species of the genus Halobellus, for which the name Halobellus rarus sp. nov. is proposed. The type strain is YC21(T) (=CGMCC 1.12121(T) = JCM 18362(T)).

Halobellus inordinatus sp. nov., from a marine solar saltern and an inland salt lake of China.

Two halophilic archaeal strains, YC20(T) and XD15, were isolated from a marine solar saltern and an inland salt lake in China. Both had pleomorphic cells that lysed in distilled water, stained Gram-negative and formed red-pigmented colonies. They were neutrophilic, requiring at least 100 g NaCl l(-1) and 0.5-95 g MgCl2 l(-1) for growth at the optimum growth temperature of 37 °C. The major polar lipids of the two strains were phosphatidylglycerol (PG), phosphatidylglycerol phosphate methyl ester (PGP-Me), phosphatidylglycerol sulfate (PGS) and two major glycolipids chromatographically identical to sulfated mannosyl glucosyl diether (S-DGD-1) and mannosyl glucosyl diether (DGD-1), respectively. Trace amounts of two unidentified glycolipids were also detected. The 16S rRNA gene sequences of the two strains were 99.5 % identical and showed 94.0-95.9 % similarity to the most closely related members of the genus Halobellus of the family Halobacteriaceae. The rpoB' gene sequence similarity between strains YC20(T) and XD15 was 98.2 % and these sequences showed 89.6-92.8 % similarity to those of the most closely related members of the genus Halobellus. The DNA G+C contents of strains YC20(T) and XD15 were 65.8 mol% and 65.4 mol%, respectively. The DNA-DNA hybridization value between strain YC20(T) and strain XD15 was 92 %, and the two strains showed low DNA-DNA relatedness to members of the genus Halobellus. The phenotypic, chemotaxonomic and phylogenetic properties suggest that strains YC20(T) and XD15 represent a novel species of the genus Halobellus, for which the name Halobellus inordinatus sp. nov. is proposed. The type strain is YC20(T) ( = CGMCC 1.12120(T) = JCM 18361(T)) and the other strain is XD15 ( = CGMCC 1.12236 = JCM 18648).

Autoimmune hemolytic anemia associated with B-cell chronic lymphoproliferative disorders / 中国实验血液学杂志

This study was purpose to investigate the clinical characteristics of B-cell chronic lymphoproliferative disorders (B-CLPD) complicated by autoimmune hemolytic anemia (AIHA) so as to improve the understanding of this disease. The clinical characteristics, laboratory data, therapy and outcome of 14 patients suffering from B-CLPD complicated by AIHA were retrospectively analyzed in Wuxi People Hospital and the First Affiliated Hospital of Nanjing Medical University from 2000 to 2012. The results showed that 9 cases of the 14 patients were patients with chronic lymphocytic leukemia (CLL), 5 cases were patients with lymphoma, at time of hemolysis the median level of hemoglobin was 61 (33 - 84)g/L, the median ratio of reticulocytes was 12.0 (3.1 - 35.0)%, the positive rate of Coombs test was 100%. 1 case received corticosteroid alone, 5 cases were treated with chemotherapy combined with corticosteroid, 8 cases were treated with immunochemotherapy rituximab combined with corticosteroid. Overall response rate was 100%, in which CR was 78.6% (11/14), PR was 21.4% (3/14). The follow-up for these patients were performed to now, 35.7% (5/14) patients relapsed with hemolysis again, but they showed therapeutic response to treatment with above-mentioned therapy. From patients treated with rituximab alone, only 1 patient relapsed. Among 14 patients, 6 cases died, 1 case was lost, the other cases are still alive. It is concluded that the AIHA is the commonest complication of B-CLPD, it can be observed at different stages of B-CLPD, the treatment with corticosteroids can give well therapeutic effect for these patients, but the long time CR is lower, the rituximab has been confirmed to be effective for B-CLPD complicated by AIHA.

Polymorphisms of FcγRIIA, FcγRIIIA and FcγRIIB in patients with immune thrombocytopenia and their clinical significance / 中国实验血液学杂志

This study was aimed to investigate the correlation of FcγR polymorphisms with the susceptibility, severity and efficacy of immunotherapy for patients with immune thrombocytopenia (ITP). PCR and DNA sequencing were used to determine the polymorphisms of FcγRIIA, FcγRIIIA and FcγRIIB in 44 ITP patients, and in 97 healthy control subjects. The results indicated that FcγRIIIA-158V/F polymorphisms between patients and controls were statistically significantly different (P = 0.015); among FcγRIIIA genotypes, the frequency of 158V/V homotype was higher in ITP (P = 0.005). However, the FcγRIIA-131H/R or FcγRIIB-232T/I polymorphisms were not significantly different between patients and controls; there were no correlation of FcγRIIA, FcγRIIIA and FcγRIIB genotype frequencies with the platelet counts or the courses of ITP; among the 38 ITP patients who received treatments, the complete response (CR) rate was 42% (16/38), and partial response (PR) rate was 34% (13/38). The therapeutic response was significantly different between FcγRIIIA-158V/V homotype and 158F/V heterotype (P = 0.034). The CR of patients with 158V/V homotype was obviously lower than that of patients with 158F/V, but the frequencies of FcγRIIA and FcγRIIB genotypes not correlated with the responsiveness to treatment. The CR rate of 6 patients treated with rituximab was 67%, and PR rate was 17%. The overall response rate was as high as 84%, the adverse reactions were not observed. It is concluded that the polymorphism of FcγRIIIA-158V/F, but not FcγRIIA-131H/R or FcγRIIB-232T/I, correlates with the patient susceptibility and therapeutic response of ITP.